A Case of Ileal Angiolipoma Causing Intussusception

Abstract

A 57-year-old woman presented to a local clinic complaining of a lump in the right lower abdomen. Abdominal ultrasound showed the target sign at the ileocecal junction, intussusception was diagnosed, and she was referred to our hospital for treatment. Computed tomography showed that the terminal ileum was invaginated into the ascending colon, and a 40-mm mass had formed at the lead point. A biopsy was conducted by colonoscopy, but this did not lead to a diagnosis, and laparoscopic surgery was performed with a diagnosis of ileal submucosal tumor. Intraoperatively, the invagination extended as far as the transverse colon, with the ileal tumor forming the lead point, and it proved difficult to reduce the intussusception laparoscopically. The ileocolic vessels were ligated laparoscopically, and the colon was mobilized as far as the hepatic flexure. A small incision was made in the umbilical region, and the intestine from the cecum to the transverse colon was brought outside the wound, where the Hutchinson procedure was used to release the intussusception, and ileocecal resection was performed. In the resected specimen, thickening of the wall of the terminal ileum was evident, and a cross-section of this region showed that a yellowish-white mass was present from the muscularis propria to the subserosa. Histopathologically, the tumor consisted of proliferating mature adipocytes and blood vessels with thickened walls, and angiolipoma was diagnosed. The patient's postoperative course was uneventful, and she was discharged on Day 9.